NPIMap

Organization Active NPI

Ajd Medical Inc

  • Gastroenterology Physician
  • New Smyrna Beach, FL
National Provider Identifier
1447595293
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
82935 Issued in FL
Legal business name
AJD MEDICAL INC
Practice address
501 Live Oak St
Suite B
New Smyrna Beach, FL 32168-7312
Phone
(386) 427-0390
Fax
(386) 427-0394
NPI assigned
Dec 5, 2012
Last updated
Dec 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Antonio DecarliNPI 1376644328
Title
Owner/Ceo
Phone
(386) 427-0390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RG0100X 82935 FL Primary

Addresses

Primary practice location

501 Live Oak St
Suite B
New Smyrna Beach, FL 32168-7312

Mailing address

501 Live Oak St
Suite B
New Smyrna Beach, FL 32168-7312
Phone (386) 427-0390

National Provider Directory

National Provider Directory
Tax ID family
Ajd Medical Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1447595293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LIVE OAK ST",
            "address_2": "SUITE B",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687312",
            "telephone_number": "386-427-0390",
            "fax_number": "386-427-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 LIVE OAK ST",
            "address_2": "SUITE B",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687312",
            "telephone_number": "386-427-0390",
            "fax_number": "386-427-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AJD MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "DECARLI",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "386-427-0390"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "82935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.